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Association between surgical excision margins and outcomes in patients with dermatofibrosarcoma protuberans: A meta‐analysis
Author(s) -
Chen Yiyin,
Jiang Guan
Publication year - 2021
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.14954
Subject(s) - medicine , dermatofibrosarcoma protuberans , meta analysis , confidence interval , relative risk , margin (machine learning) , cochrane library , surgical margin , malignancy , subgroup analysis , observational study , surgical excision , surgery , oncology , resection , dermatology , machine learning , computer science
Dermatofibrosarcoma protuberans (DFSP) is a tumor with low‐grade malignancy and high recurrence rates. Wide local excision (WLE) is essential for DFSP, but its surgical excision margin is controversial. This study aimed to examine whether resection margin is associated with the prognosis of patients with DFSP by systematically reviewing related literature. Studies that evaluated the relationship between excision margins and outcomes after WLE were retrieved from the Cochrane Library, PubMed, Embase, and Web of Science databases. Relative risk (RR) estimates and 95% confidence intervals (CIs) were measured via a random‐effect model to evaluate the subsequent outcomes: recurrence rate, mortality, and positive surgical margin rate. Sensitivity and subgroup analyses were simultaneously carried out. The meta‐analysis of eight observational literatures demonstrated a significant positive correlation of ≥3 cm margin with the recurrence rate (RR = 0.17, 95% CI 0.09‐0.31) and the positive surgical margin rate (RR = 0.09, 95% CI 0.02‐0.46). The same result was observed in the recurrence rate in all subgroups. The stability of the above outcomes was authenticated via sensitivity analyses. Our meta‐analysis illustrated that excision with <3 cm surgical margin exhibited an increased risk of poor DFSP prognosis (high recurrence rate and increasing positive margin rate).